Pediatric reference intervals for soluble transferrin receptor and transferrin receptor-ferritin index
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
Recent studies showing an improved diagnosis of iron deficiency (ID) with soluble transferrin receptor (sTfR) and sTfR-ferritin index did not take into account the age-dependency of sTfR and ferritin. Moreover, there is a paucity of data on pediatric reference intervals for sTfR and sTfR-ferritin index.
A study cohort of 436 apparently healthy children was analyzed to establish reference intervals for ferritin, transferrin, sTfR and sTfR-ferritin index. To account for age-dependency, standard deviation scores (Z-scores) for these markers were calculated. The association between these parameters and C-reactive protein (CRP) was analyzed.
The Z-scores of ferritin, transferrin and sTfR had a significant association with CRP, whereas the Z-score of sTfR-ferritin did not correlate with CRP. The reference intervals of these parameters were reported.
Among the different markers of ID, the Z-scores of sTfR, transferrin and ferritin, but not sTfR-ferritin index, associate with the inflammatory status.
- Soldin OP, Bierbower LH, Choi JJ, Choi JJ, Thompson-Hoffman S, Soldin SJ. Serum iron, ferritin, transferrin, total iron binding capacity, hs-CRP, LDL cholesterol and magnesium in children; new reference intervals using the Dade Dimension Clinical Chemistry System. Clin Chim Acta 2004;342:211–217. CrossRef
- Moy RJ. Prevalence, consequences and prevention of childhood nutritional iron deficiency: a child public health perspective. Clin Lab Haematol 2006;28:291–298. CrossRef
- Looker AC, Dallman PR, Carroll MD, Gunter EW, Johnson CL. Prevalence of iron deficiency in the United States. JAMA 1997;277:973–976. CrossRef
- Cook JD, Skikne BS, Baynes RD. Serum transferrin receptor. Annu Rev Med 1993;44:63–74. CrossRef
- Beguin Y. Soluble transferrin receptor for the evaluation of erythropoiesis and iron status. Clin Chim Acta 2003;329:9–22. CrossRef
- Virtanen MA, Viinikka LU, Virtanen MK, Svahn JC, Anttila RM, Krusius T, et al. Higher concentrations of serum transferrin receptor in children than in adults. Am J Clin Nutr 1999;69:256–260.
- Cermak J, Brabec V. Transferrin receptor-ferritin index: a useful parameter in differential diagnosis of iron deficiency and hyperplastic erythropoiesis. Eur J Haematol 1998;61:210–212. CrossRef
- Vazquez Lopez MA, Carracedo A, Lendinez F, Munoz FJ, Lopez J, Munoz A. The usefulness of serum transferrin receptor for discriminating iron deficiency without anemia in children. Haematologica 2006;91:264–265.
- Suominen P, Punnonen K, Rajamaki A, Irjala K. Serum transferrin receptor and transferrin receptor-ferritin index identify healthy subjects with subclinical iron deficits. Blood 1998;92:2934–2939.
- Kasvosve I, Gomo ZA, Nathoo KJ, Matibe P, Mudenge B, Gordeuk VR. Reference intervals of serum transferrin receptors in pre-school children in Zimbabwe. Clin Chim Acta 2007;382:138–141. CrossRef
- Asobayire FS, Adou P, Davidsson L, Cook JD, Hurrell RF. Prevalence of iron deficiency with and without concurrent anemia in population groups with high prevalences of malaria and other infections: a study in Cote d’Ivoire. Am J Clin Nutr 2001;74:776–782.
- Lammi-Keefe CJ, Lickteig ES, Ahluwalia N, Haley NR. Day-to-day variation in iron status indexes is similar for most measures in elderly women with and without rheumatoid arthritis. J Am Diet Assoc 1996;96:247–351. CrossRef
- Ferguson BJ, Skikne BS, Simpson KM, Baynes RD, Cook JD. Serum transferrin receptor distinguishes the anemia of chronic disease from iron deficiency anemia. J Lab Clin Med 1992;119:385–390.
- Dimitriou H, Stiakaki E, Markaki EA, Bolonaki I, Giannakopoulou C, Kalmanti M. Soluble transferrin receptor levels and soluble transferrin receptor/log ferritin index in the evaluation of erythropoietic status in childhood infections and malignancy. Acta Paediatr 2000;89:1169–1173. CrossRef
- Reynolds P. Newborns have unique confounding factors regarding the TfR-F ratio. Arch Dis Child Fetal Neonatal Ed 2001;85:F146. CrossRef
- Semba RD, Kumwenda N, Hoover DR, Taha TE, Mtimavalye L, Broadhead R, et al. Assessment of iron status using plasma transferrin receptor in pregnant women with and without human immunodeficiency virus infection in Malawi. Eur J Clin Nutr 2000;54:872–877. CrossRef
- Wians FH Jr, Urban JE, Keffer JH, Kroft SH. Discriminating between iron deficiency anemia and anemia of chronic disease using traditional indices of iron status vs. transferrin receptor concentration. Am J Clin Pathol 2001;115:112–118. CrossRef
- Wians FH Jr, Urban JE, Kroft SH, Keffer JH. Soluble transferrin receptor (sTfR) concentration quantified using two sTfR kits: analytical and clinical performance characteristics. Clin Chim Acta 2001;303:75–81. CrossRef
- Ritchie B, McNeil Y, Brewster DR. Soluble transferrin receptor in Aboriginal children with a high prevalence of iron deficiency and infection. Trop Med Int Health 2004;9:96–105. CrossRef
- Vlug A, Nieuwenhuys EJ, van Eijk RV, Geertzen HG, van Houte AJ. Nephelometric measurements of human IgG subclasses and their reference ranges. Ann Biol Clin (Paris) 1994;52:561–567.
- Abellan R, Ventura R, Pichini S, Sarda MP, Remacha AF, Pascual JA, et al. Evaluation of immunoassays for the measurement of soluble transferrin receptor as an indirect biomarker of recombinant human erythropoietin misuse in sport. J Immunol Methods 2004;295:89–99. CrossRef
- Malope BI, MacPhail AP, Alberts M, Hiss DC. The ratio of serum transferrin receptor and serum ferritin in the diagnosis of iron status. Br J Haematol 2001;115:84–89. CrossRef
- Kratovil T, DeBerardinis J, Gallagher N, Luban NL, Soldin SJ, Wong EC. Age specific reference intervals for soluble transferrin receptor (sTfR). Clin Chim Acta 2007;380:222–224. CrossRef
- Siddappa AM, Rao R, Long JD, Widness JA, Georgieff MK. The assessment of newborn iron stores at birth: a review of the literature and standards for ferritin concentrations. Neonatology 2007;92:73–82. CrossRef
- Zoli A, Altomonte L, Mirone L, Magaró M, Ricerca BM, Storti S, et al. Serum transferrin receptors in rheumatoid arthritis. Ann Rheum Dis 1994;53:699–701. CrossRef
- Revel-Vilk S, Tamary H, Broide E, Zoldan M, Dinari G, Zahavi I, et al. Serum transferrin receptor in children and adolescents with inflammatory bowel disease. Eur J Pediatr 2000;159:585–589. CrossRef
- Juncà J, Fernández-Avilés F, Oriol A, Navarro JT, Millá F, Sancho JM, et al. The usefulness of the serum transferrin receptor in detecting iron deficiency in the anemia of chronic disorders. Haematologica 1998;83:676–680.
- Punnonen K, Irjala K, Rajamaki A. Serum transferrin receptor and its ratio to serum ferritin in the diagnosis of iron deficiency. Blood 1997;89:1052–1057.
- Pediatric reference intervals for soluble transferrin receptor and transferrin receptor-ferritin index
World Journal of Pediatrics
Volume 5, Issue 2 , pp 122-126
- Cover Date
- Print ISSN
- Online ISSN
- SP Children’s Hospital, Zhejiang University School of Medicine
- Additional Links
- C-reactive protein
- reference interval
- soluble transferrin receptor
- soluble transferrin receptor-ferritin index
- Author Affiliations
- 1. Department of Pediatrics, Children’s Hospital, London Health Science Centre, Schulich School of Medicine & Dentistry, University of Western Ontario, 800 Commissioners Road East, London, Ontario, N6A 7W9, Canada
- 2. Department of Pathology and Laboratory Medicine, Children’s Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Canada, K1H 8L1
- 3. Sanquin Diagnostic Services, Amsterdam, The Netherlands